先天性肛门闭锁直肠远端神经节细胞及cajal细胞分布研究

Distributions of Ganglia and Cajal Cells in Congenital Imperforate Anus

目的:了解神经丛、神经节细胞和cajal间质细胞在先天性肛门闭锁患儿直肠末端中的分布情况并探讨其意义。方法:应用HE方法和免疫组化SP法检测23例先天性肛门闭锁患儿直肠末端肠壁内神经丛、神经节细胞分布以及神经元特异性烯醇化酶(NSE)、酸性钙结合蛋白S-100、兔抗人c-kit抗体的表达情况。结果:本组患儿病理所见直肠末端神经丛分布稀疏,神经节细胞减少或缺失;高位闭锁组黏膜下层、肌间神经丛明显低于低位闭锁组(均P<0.05);NSE及c-kit在高位闭锁组未见阳性表达。结论:高位肛门闭锁直肠末端肠壁内神经节细胞、神经丛和cajal细胞少于低位闭锁组,可能影响直肠末端肠道运动功能,导致术后排便功能障碍。

Objective： To evaluate the distributions of ganglia and cajal cells in congenital imperforate anus and to discuss the clinic significance. Methods： The distributions of ganglia, myenteric plexuses, neuron-specific enolase （NSE） acidic calcium binging protein S-100 and rabbit anti-human c-kit antibody （c-kit） were detected by HE staining and immunohistochemical analysis in patients with congenital imperforate anus. Results： HE staining showed that decreased proportion of ganglia and myenteric plexuses in the anus samples of patients with congenital imperforate anus. A significantly higher proportion of myenteric plexuses was found in low-position imperforate anus than that in superior position imperforate anus （submucosa group t′= 10.906, P 0.05;myenteric group t′= 9.378,P 0.05）. There were no positive expression of NSE and c-kit in superior position imperforate anus. Conclusion： The postoperative defecation disorders may be related to the decrease of interstitial cells of cajal and ganglia in the myenteric plexuses.